- 4 weeks ago I had an encounter at an Asian massage parlor that included me receiving an unprotected handjob. During the handjob I was concerned that she briefly used her mouth, but unsure. 

- the lady had a fat lip, which I have now started to worry was a chancre. I assume she could reasonably have come in contact with an infected penis in her line of work. 

- as of about 4 days ago, I have a round red sore on the head of my penis and some friction chaffing on the shaft of my penis below the red spot. It started as a red blemish appearing like a friction burn maybe. It has now turned into more of a scab almost and appears slightly cratered. My first assumption was that this was just from masturbation friction, which has happened to me in the past but now I am more worried. It does seem to be healing well and has shrunk a decent amount in the past 4 days. 

- I went to get a 10 panel test today and am anxiously awaiting results. 

Do you feel that these results will be conclusive or would you recommend another test in a couple of weeks?

Overall, the encounter you describe was low risk- most commercial sex workers do not have syphilis (or other STIs, including HIV) and most exposures do not lead to infection (about 1/3 do).  Typically, had you acquired syphilis, most typically a chancre would have appeared within 3 weeks of exposure and a syphilis lesion would be unlikely to be healing just 4 days after it appeared.  On the other hand, syphilis is occasional, although not often, acquired from receipt of oral sex. and a syphilis blood test may (rarely) not be positive until a lesion had been present for 5 days.  

Your preliminary negative test as well as the factors mentioned above make it unlikely that that the lesion you describe is  syphilis.  That said and suspecting that you would like a more definitive response, my advice would be to re-test for syphilis at 6 weeks.  Testing for other, more common STIs such as gonorrhea and chlamydia at this time will provide conclusive results.  I anticipate that further testing will show that you you did not acquire syphilis, or any other STI and urge you not to worry.  EWH

Also, I am 90% sure this woman did not touch my penis with her mouth, as that was not what we had discussed.

I would love to be able to go back to having normal worry-free sex with my partner, but it sounds like I need to wait a couple of more weeks for a conclusive result.  Is that still your recommendation based on all of this info?

Thank you for your help and your calming words of advice. 

Does this description of the lesion sound like a chancre in your opinion:

- appeared after masturbating along with another painful lesion 1.5 inches directly below. Initial thought was friction from masturbating, which has happened to me many times in the past.  This happened around 4 weeks after potential exposure. 

- lesion on head of penis started off looking like a red blemish from friction. Then, after a couple of days, turned into a wound that had puss every once in a while. It scabbed over around day 3 and I am on day 5-6. The scab is continuing to shrink each day. The healing around the scab is what has given it a potentially crater-like appearance, but I am not certain that there is actually an indentation. If so, it is very minor. 

- the wound is currently less than a centimeter in diameter. It is circular, although it didn’t start out that way, as it was more of an uneven blemish. 

I am having extreme anxiety and cannot sleep due to what I thought was going to be an almost zero-risk exposure. I appreciate all of your feedback. 

Thank you again. 

For the reasons I’ve already outlined, this would be uncharacteristic for a chancre but syphilis lesions can vary.  I remain doubtful that your lesion is a chancre.

End of thread.  Closing this shortly.  Try to relax.  EWH